fficacy and Cost-effectiveness of TuberculosisPolymerase Chain Reaction (TB-PCR) Test Comparing to Acid Fast Staining for Diagnosis of Tuberculosis inThammasat University Hospital

Mycobacterium tuberculosis (MTB) culture is a gold standard method for detection of MTB, while acid fast staining method, which has low sensitivity, is used for screening of TB infection. The aim of this study was to evaluate efficacy and cost effectiveness of real time PCR comparing to acid fast staining for the detection of TB. Anyplex TM plus MTB/NTM Detection (V1.1) kit was based on real-time PCR technique and is used as screening method for direct detection of MTB complex from 108 lower respiratory tract specimens of patients in Thammasat University Hospital. After that, positive MTB detection was continued to detect drug resistance using Anyplex TM  plus MDR-TB detection (V1.1) kit. The results showed that acid-fast bacilli (AFB) stain, culture and real-time PCR positive were 10 (9.25%), 12 (11.11%) and 19 (17.59%), respectively. Among 19 of real time PCR positive, 18 were positive for MTB and 1 was non-tuberculosis Mycobacteria (NTM). Only 1 from 18 MTB positive sample was multidrug-resistant. Real-time PCR was significantly better than acid fast stain for screening MTB in the lower respiratory specimens. Cost effectiveness of real-time PCR and AFB staining method was 0.0011 and 0.0553, respectively. In conclusion, real-time PCR method can detect MTB better than AFB staining method. Moreover, PCR method is more cost-effective than AFB staining method.